Provider Demographics
NPI:1326366642
Name:AKHTAR, SHAZIA (DDS)
Entity Type:Individual
Prefix:MS
First Name:SHAZIA
Middle Name:
Last Name:AKHTAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28-39 214TH PL
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-2625
Mailing Address - Country:US
Mailing Address - Phone:718-902-2740
Mailing Address - Fax:
Practice Address - Street 1:28-39 214TH PL
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2625
Practice Address - Country:US
Practice Address - Phone:718-229-1916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist